Saturday, May 23, 2009

Why can some people sleep like the dead and yet others are stuck counting a herd of sheep. For many insomnia sufferers the cause can come from medical problems such as chronic pain, asthma or other respiratory illnesses. Depression alone can cause insomnia and visa versa...sleep deprivation can actually cause depression, so it then becomes a vicious cycle.

Some drugs used to treat cardiovascular disease, arthritis and cancer have a side effect of sleeplessness. Lastly but not least there is sleep apnea and restless leg syndrome which can cause someone to fall into the black hole of insomnia. As for primary insomnia it seems to have people stumped. It tends to occur in people that have a hyper-aroused nervous system that makes it hard to either drift off to sleep or get back to sleep.

It also is more likely in women and people over the age of 55. After many years of researching primary insomnia there seems to be one treatment that has soared above the rest. It's called cognitive-behavioral therapy or CBT-I. CBT-I is a form of temporary psychotherapy that helps people correct mistaken beliefs about sleep and change poor sleep habits.

Jack Edinger, Ph.D., a psychologist at Veterans Affairs Medical Center in Durham, N.C. has conducted many studies comparing CBT-1 to other insomnia treatments. While sleep hygiene and relaxation techniques have helped people fall asleep it didn't help them stay them asleep. "Patients keep getting better and better with this treatment," says Michael Perlis Ph.D., Director of the university of Rochester Sleep and Neurophysiology Research Laboratory. Perlis continues to say "CBT-I has actually changed tender sleepers into robust sleepers."

The study showed that just two to four sessions of CBT-I have shown large improvements in patients sleep maintenance with even better results at a six-month follow up. Perlis continued by saying "of all the problems that continue with age, this is one of the most fixable."

You need to have self discipline when starting this therapy but when your sleep returns to you "in all it's glory"--- it makes it all worth it. It's hard for some sufferers to grasp that they might actually have to get a little less sleep in the beginning stages of this treatment. The thought of no naps and no reading in bed can be hard to adjust to.

But once they stick to the rules their sleep starts to improve dramatically. Over a short amount of time there are more good sleep nights than poor nights and the trust starts to build. People start to rebuild their confidence in their ability to sleep well and anxiety starts to disappear.

Susan Roberts a school psychologist in Washington, DC states "if you can sleep for only six hours but you're in bed for eight, that's a sleep efficiency of 75 percent. To increase this number to 90 percent or more, the therapist will cut back the time you're in bed, so if you usually go to bed at 10:00 you're now go to bed at 12:00."This is the most important rule DON'T BE IN BED AWAKE. Rachel Norwood MD a psychiatrist at the national Jewish Medical and research Center in Denver says "you want the feel, the smell, and sight of the bed to become cues telling your brain it's time to go to sleep". Expect the more time you're in bed awake to make your sleep worse.

With the CBT-I treatment if the patient wakes up they should not lay in bed for more than 20 minutes. The patient is instructed to leave the bed and go to another room to read--- when they feel tired they can go back to bed. They repeat this ritual until they fall asleep. I have found that this practice is imperative to getting back on the right track. This treatment is all based on sleep wake cycles and getting the mind to associate your bed with sleeping.

At the start, getting up out of bed in the morning when you've only gotten 4 or 5 hours sleep can be brutal. But you will see that after about a week or even just a few days that your sleep will be deep and with less awakenings. I couldn't believe I was actually getting 7 hours of sleep. I continue to be amazed with the results from this treatment not to mention my morning order of venti lattes can now be downsized to a 'grande' and life looks a whole lot brighter.